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    <title>Discriminant Score Calculator (for neonatal aortic stenosis)</title>

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<h1>Discriminant Score Calculator</h1>
<h2><a href="#patients" rel="#patients" title="Inclusion Criteria">for neonatal critical aortic stenosis</a></h2>
    <table id="rhodes">
        <tr>
            <td>
                <label for="ht">Height (cm):</label>
            </td>
            <td>
                <input type="text" name="ht" id="ht" />
            </td>
        </tr>
        <tr>
            <td>
                <label for="wt">Weight (kg):</label>
            </td>
            <td>
                <input type="text" name="wt" id="wt" /></td>
        </tr>
        <tr>
            <td>
                <label>BSA (m<sup>2</sup>):</label>
            </td>
            <td id="bsa">
                &nbsp;
            </td>
        </tr>
        <tr>
            <td>
                <label for="aov">Aortic Annulus (cm):</label>
            </td>
            <td>
                <input type="text" name="aov" id="aov" />
                <img src="images/information.png" class="tooltip" rel="#aovtip" title="Measuring the Aortic Annulus:" />
            </td>
        </tr>
        <tr>
            <td>
                <label>Aortic Valve Z-Score:</label></td>
            <td id="aovz">
                &nbsp;
            </td>
        </tr>
        <tr>
            <td>
                <label for="lvlax">Left Ventricular Long Axis:</label></td>
            <td>
                <input type="text" name="lvlax" id="lvlax" />
                <img src="images/information.png" class="tooltip" rel="#lvlaxtip" title="Measuring the LV Long Axis:" />
                </td>
        </tr>
        <tr>
            <td>
                <label for="heartlax">Heart Long Axis:</label>
            </td>
            <td>
                <input type="text" name="heartlax" id="heartlax" />
                <img src="images/information.png" class="tooltip" rel="#heartlaxtip" title="Measuring the Heart Long Axis:" />
            </td>
        </tr>
        <tr>
            <td>
                <label for="lar">Long Axis Ratio:</label>
            </td>
            <td id="lar">
            &nbsp;    
            </td>
        </tr>
        <tr>
            <td>
                <label for ="efe">EFE Grade:</label>
            </td>
            <td>
                <select name="efe" id="efe">
                    <option value="false" title="omit from analysis">omit</option>
                    <option value="0" title="none" selected="selected">0 = none</option>
                    <option value="1" title="involvement of papillary muscles only">1 = paps</option>
                    <option value="2" title="papillary muscle with some endocardial surface involvement">2 = some</option>
                    <option value="3" title="extensive endocardial surface involvement">3 = extensive</option>
                </select>
                <img src="images/information.png" class="tooltip" rel="#efetip" title="Presence/Grade of EFE:" alt="efe tooltip" />
            </td>
        </tr>
        <tr>
            <td>
            </td>
            <td>
                <input id="Button1" type="button" value="Update" onclick="calcDiscriminant()"/>
            </td>
        </tr>
        <tr>
            <td></td>
            <td>
                <input id="Button2" type="button" value="Reset" onclick="window.location.reload()"/>
            </td>
        </tr>
        </table>
<div id="interpretation">
<h3>Discriminant Score:&nbsp;<span id="results"></span></h3>
    <p>
        <span id="efeCutoff">Taking a discriminant cutoff of -0.65, this model accurately predicted
            outcome in 95% of survivors and 80% of events (90% overall)</span>. Higher cutoff
        values allowed slightly improved specificity at the expense of sensitivity. The
        greatest specificity while maintaining &gt;85% sensitivity for predicting survival
        with a biventricular repair was at a discriminant cutoff of &lt;-0.46, which predicted
        outcome accurately in 86% of survivors and 82% of events.</p>
    <p id="cutoff">
        If EFE is omitted from the analysis (owing to high interobserver variability in
        grading), a discriminant cutoff of -0.46 accurately predicted 91% of survivors and
        80% of events (87% overall).</p>
</div>
<div id="tips">
<p id="patients">
The new study cohort included patients who met
the criteria specified in our original report: 1) surgical or
balloon aortic valvuloplasty for valvar AS, 2) echocardiographic
evidence of LV dysfunction and symptoms of
congestive heart failure, 3) normally related great arteries,
4) <i>absence of subvalvar/supravalvar AS</i>, 5) <i>intact ventricular
septum</i>, 6) no prior procedures on the aortic valve, and
7) adequate pre-intervention echocardiographic images to
make all pertinent measurements. The presence of a patent
ductus arteriosus was not considered in determining study
eligibility. Mitral valve size was not considered for study
inclusion.</p>
<p id="aovtip">
Aortic annulus diameters were measured
from parasternal long-axis images.</p>
<p id="lvlaxtip">
The long-axis length of the left ventricle is measured as the distance from the plane of the mitral valve annulus to the apex of the ventricle.
</p>
<p id="heartlaxtip">The long axis of the heart is measured from the apical four chamber view as the distance from the crux of the heart to the apical endocardium (either right or left ventricle, whichever formed the apex of the heart).
</p>
<p id="efetip">
0 = none<br /> 
1 = involvement of MV papillary
muscles only<br /> 
2 = involvement of papillary muscles and
some endocardial surface<br />
3 = extensive endocardial
surface involvement.<br />
<br />
Owing to high interobserver variability in grading, EFE can also be omitted from the analysis.
</p>
</div>
<p class="references">
    <a href="http://content.onlinejacc.org/cgi/content/full/47/9/1858" title="link to JACC Online">Validation and Re-Evaluation of a Discriminant Model Predicting Anatomic Suitability
     for Biventricular Repair in Neonates With Aortic Stenosis</a>
     <br />
     Steven D. Colan, Doff B. McElhinney, Elizabeth C. Crawford, John F. Keane, and James E. Lock<br />
     J. Am. Coll. Cardiol. 2006;47;1858-1865
</p>
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